title: Prognostic value of chronic hepatitis B virus infection in patients with nasopharyngeal carcinoma: analysis of 1301 patients from an endemic area in China.
abstract: BACKGROUND
  The current study investigated the prevalence and prognostic value of chronic hepatitis B virus (HBV) infection in patients with nasopharyngeal carcinoma (NPC) from an area in southern China in which HBV and NPC are endemic.
  
  
  METHODS
  A total of 1301 patients with nonmetastatic, histologically proven NPC who were treated with radiotherapy or chemoradiotherapy were retrospectively reviewed.
  
  
  RESULTS
  In this series, 142 of the 1301 patients (10.9%) had chronic HBV infection (hepatitis B surface antigen [HBsAg] seropositive). The percentages of non-cancer-related deaths (15.0% vs 12.1%; P = .618) and severe hepatic adverse events (3.5% vs 0.9%; P = .145) were similar among patients with NPC with and without HBV infection. The 5-year overall survival (OS), progression-free survival (PFS), and locoregional recurrence-free survival (LRFS) rates for patients with NPC with or without HBV infection were 70.9% and 80.8% (P = .003), 63.7% and 73.0% (P = .016), and 81.7% and 88.2% (P = .035), respectively. Multivariate analysis identified chronic HBV infection in patients with NPC as an independent unfavorable prognostic factor for OS (hazards ratio [HR], 1.684; P = .003), PFS (HR, 1.451; P = .015), and LRFS (HR, 1.573; P = .048). Further analysis revealed that chronic HBV infection was an unfavorable, independent prognostic factor in patients with locoregionally advanced NPC, but not those with early-stage disease. In patients with stage III/IV NPC, HBsAg-positive patients had poorer OS (64.0% vs 77.2%; P = .003), PFS (56.2% vs 70.6%; P = .004), and LRFS (76.2% vs 88.3%; P = .002) compared with HBsAg-negative patients. On multivariate analysis, chronic HBV infection was found to be an independent adverse prognostic predictor for OS (HR, 1.734; P = .004), PFS (HR, 1.644; P = .003), and LRFS (HR, 2.108; P = .003) in patients with stage III/IV NPC.
  
  
  CONCLUSIONS
  Chronic HBV infection is an independent adverse prognostic factor in patients with locoregionally advanced NPC.
authors.affiliation: State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Xu
authors.initials: X
authors.lastname: Liu
authors.forename: Xing
authors.initials: X
authors.lastname: Li
authors.forename: Ning
authors.initials: N
authors.lastname: Jiang
authors.forename: Ying
authors.initials: Y
authors.lastname: Lei
authors.forename: Ling-Long
authors.initials: LL
authors.lastname: Tang
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
authors.forename: Guan-Qun
authors.initials: GQ
authors.lastname: Zhou
authors.forename: Ying
authors.initials: Y
authors.lastname: Sun
authors.forename: Dan
authors.initials: D
authors.lastname: Yue
authors.forename: Rui
authors.initials: R
authors.lastname: Guo
authors.forename: Yan-Ping
authors.initials: YP
authors.lastname: Mao
authors.forename: Wen-Fei
authors.initials: WF
authors.lastname: Li
authors.forename: Li-Zhi
authors.initials: LZ
authors.lastname: Liu
authors.forename: Li
authors.initials: L
authors.lastname: Tian
authors.forename: Ai-Hua
authors.initials: AH
authors.lastname: Lin
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
mesh_terms: D002277:Carcinoma; D002681:China / Q000453:epidemiology; D019353:Endemic Diseases; D005260:Female; D019694:Hepatitis B, Chronic / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000821:virology*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: comorbidity; drug toxicity; hepatitis B virus; nasopharyngeal neoplasms; prognosis